Knowledge Centre
Providing rapid medical guidance and expert health insights for informational purposes. Our guides come from a Harley Street clinic, but they do not replace a professional consultation.
Mammogram or breast ultrasound: which do you need?
Written by Mr Stephen Lingam · Reviewed by Dr Penny Sheehan (GMC 6056535) on 25/09/2026
Key takeaways
- A mammogram is a low-dose X-ray and is the standard screening test for breast cancer; a breast ultrasound uses sound waves and works better on dense breast tissue or a specific area of concern.
- At Medical Express Clinic, a mammogram is £245 with results in 3 working days, and a breast ultrasound is £450 with results in 24 to 48 hours.
- Private screening mammograms are normally offered from age 40; under 40, ultrasound is usually the first scan for a breast concern, because younger breast tissue tends to be denser.
- Neither scan is performed at 117a Harley Street itself; both are carried out at a specialist partner imaging centre, with the details arranged when you book.
- A new lump or breast change should be assessed by a doctor first, so your GP can recommend the imaging that fits your situation rather than choosing blind.
A mammogram is a low-dose X-ray used as the standard screening test for breast cancer, while a breast ultrasound uses sound waves and is often better suited to dense breast tissue or investigating a specific area. For routine screening, a mammogram is usually the starting point; for a new lump, younger women, or dense tissue, your doctor may recommend ultrasound instead or alongside it.
What's the difference between a mammogram and a breast ultrasound?
A mammogram uses a low-dose X-ray to image the breast and is the standard screening test for breast cancer, able to show changes before they can be felt. A breast ultrasound uses high-frequency sound waves instead of X-rays, producing real-time images that can show a specific area in dense tissue and tell a solid lump from a fluid-filled cyst. For many women, the most complete picture comes from the two scans together rather than either alone.
The table below sets out what each scan is for, the age it typically suits, and the price.
| Scan | What it's for | Typically suits | Price |
|---|---|---|---|
| Mammogram | Standard breast cancer screening; can show changes before they can be felt | Screening, normally from age 40 | £245 |
| Breast ultrasound | Dense tissue, investigating a specific lump or area, distinguishing solid masses from cysts | Women under 40 with a breast concern, dense breasts, a new lump, pregnancy or breastfeeding | £450 |
| Breast MRI | The most detailed imaging, for high-risk screening or further assessment of another finding | High-risk women, including known BRCA1 or BRCA2 carriers, or unclear findings on mammogram or ultrasound | £750 |
A breast MRI is not a routine first test; it is usually kept for women at high risk or for a finding that needs more detail.
Why does breast density change which scan is better?
Denser breast tissue makes a mammogram less sensitive, because dense tissue and potential abnormalities can both appear white on the X-ray image, making small changes harder to spot. Breast density varies between women and changes with age, hormonal status and body composition; if you've been told you have dense breasts, ask your doctor whether adding ultrasound to your mammogram makes sense for you, because it can show some changes that dense tissue may hide on a mammogram.
Does age affect which scan I should have?
Women under 40 tend to have denser breast tissue, which makes mammography less sensitive, so ultrasound is usually the first scan for a breast concern in younger women. Private screening mammograms are normally offered from age 40. The NHS Breast Screening Programme invites women for a mammogram every 3 years from age 50 to 70. A private mammogram lets women outside those ages or intervals book directly, and your doctor can advise if you are at higher risk because of your family history. If you would like breast imaging as part of a wider screening package, our sister clinic Health Screening Clinic offers private breast cancer screening.
I've found a lump. Which scan should I book?
If you've found a new lump or breast change, see a GP first rather than booking imaging directly. Your doctor examines you and recommends the most appropriate scan: in some cases ultrasound is more informative than mammography for investigating a specific lump, particularly in younger women, while a mammogram may be the right next step for others. A GP consultation is £150, and same-day appointments for a breast lump assessment are available. Most patients can be scanned at a partner imaging centre on the same day as their consultation.
What about pregnancy or breastfeeding?
Ultrasound involves no radiation, so it is usually the first scan for a breast concern during pregnancy or breastfeeding. If you're pregnant or breastfeeding and have a breast concern, mention this when you book so the right scan is arranged.
Where are mammograms and breast ultrasounds carried out?
Neither scan takes place at 117a Harley Street itself. Both a mammogram and a breast ultrasound are carried out at a specialist partner imaging centre near the clinic, with location and preparation details provided when you book. Your GP consultation and results review, however, take place at 117a Harley Street. Mammograms and breast ultrasounds are available Monday to Friday, and no referral is needed for either.
Sources
Mr Stephen Lingam
Managing Director
Executive leadership
Frequently asked questions
Can I have both a mammogram and an ultrasound?
Yes, and for many women the most complete picture comes from mammography and ultrasound together, particularly if you have dense breast tissue or a finding that needs further clarification.
Does a mammogram hurt more than an ultrasound?
A mammogram involves brief compression of the breast between two plates, usually described as uncomfortable rather than painful; a breast ultrasound involves no compression, no radiation and no pain, only gel and a handheld probe.
How quickly will I get my results?
A mammogram reports within 3 working days and a breast ultrasound within 24 to 48 hours, with a detailed written report sent to you.
Do I need a referral for either scan?
No, both can be booked directly without a GP letter, though referral letters are welcomed if you already have one.
Is a breast MRI ever needed instead?
A breast MRI, £750, is the most detailed breast imaging available and is generally reserved for high-risk screening, such as known BRCA1 or BRCA2 carriers, or for further assessment when a mammogram or ultrasound finding needs more clarity.
What happens if either scan finds something?
Your consultant radiologist details the finding in your report, and further investigation, such as additional imaging or a referral to a breast specialist, is coordinated directly rather than leaving you to arrange it yourself.
Need Professional Advice?
While our Knowledge Centre provides expert insights, it does not replace a face-to-face consultation with a doctor.
